Role of Pyridoxine (Vitamin B6) in the treatment of Levetiracetam induced behavioral effects in Epilepsy patients.
Abstract number :
1.308
Submission category :
7. Antiepileptic Drugs / 7D. Drug Side Effects
Year :
2017
Submission ID :
344424
Source :
www.aesnet.org
Presentation date :
12/2/2017 5:02:24 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Kalyan Sajja, Creighton University School of Medicine; Rammohan Sankaraneni, Creighton University School of Medicine; Krishna Galla, Creighton University School of Medicine; and Sanjay P. Singh, Creighton University School of Medicine
Rationale: Levetiracetam is one of the most commonly used antiepileptic medications in the United States. In clinical studies, 13% of adult Keppra-treated patients compared to 6% of placebo treated patients experienced non-psychotic behavioral symptoms (aggression, anger, emotional lability, anger, depression, anxiety). There is a paucity of data regarding the treatment of behavioral adverse effects of Levetiracetam. Behavioral side effects are one of the most important causes of discontinuing Levetiracetam. In this study we explore the benefit of giving pyridoxine supplementation to such patients who are experiencing behavioral side effects due to Levetiracetam. Methods: A retrospective review of our electronic medical records identifying all the patients from the Creighton University Epilepsy Center Clinic from 2011 to 2015 to identify those who were on Levetiracetam and were then started on pyridoxine by our Epileptologists. We identified 45 such patients out of 380 patients on Levetiracetam. These 45 patients had significant behavioral side effects and were started on Pyridoxine 100mg per day for control of these symptoms. The median Levetiracetam dose in these patients was 1000mg in a day and the highest dose was 4000mg/day. Results: Behavioral side effects were seen in 11.8% of patients treated with Levetiracetam. Most commonly seen side effects were agitation, insomnia and irritability. These effects were usually seen within the first 4 weeks of initiation of Levetiracetam therapy.?Of those 45 who received Pyridoxine, 42 (93.3%) patients continued to be on Levetiracetam as they had significant improvement in their behavioral symptoms. This benefit is seen across the entire range of Levetiracetam dosing. Conclusions: Pyridoxine 100mg daily can be an effective treatment of the behavioral side effects related to the use of Levetiracetam. It allows the continued use of this important antiepileptic drug. A large multicenter prospective randomized controlled trial can help further confirm this benefit. Funding: None
Antiepileptic Drugs